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Enhanced suppression of cortisol following dexamethasone administration in posttraumatic stress disorder
Abstract
OBJECTIVE: The authors investigated the possibility of enhanced negative feedback sensitivity of the hypothalamic-pituitary-adrenal (HPA) axis in posttraumatic stress disorder (PTSD) by using a low dose of dexamethasone. METHOD: Baseline blood samples were obtained at 8:00 a.m., and 0.5 mg of dexamethasone was administered to 21 male patients with PTSD and 12 normal age-comparable men at 11:00 p.m. Cortisol and dexamethasone levels were measured 9 and 17 hours after dexamethasone administration. RESULTS: After correction for differences in dexamethasone levels, the PTSD patients showed greater suppression of cortisol in response to dexamethasone than did the normal subjects. This was true even in patients meeting concurrent diagnostic criteria for major depression. CONCLUSIONS: The data support earlier studies showing that HPA abnormalities in PTSD are different from those seen in depression and suggest that the low-dose dexamethasone suppression test may be a potentially useful tool for differentiating the two syndromes and further exploring differences in their pathophysiology.
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“Enhanced ASR and HPA-negative feedback have been reliably observed in patients with PTSD (Shalev et al, 1992;Yehuda et al, 1993;Orr et al, 1997).”
From Cannabinoids prevent the development of behavioral and endocrine alterations in a rat model of intense stress (2012) · cites this paper as Yehuda et al, 1993
In the citing paper
“Enhanced ASR and HPA-negative feedback have been reliably observed in patients with PTSD (Shalev et al, 1992;Yehuda et al, 1993;Orr et al, 1997).”
From Cannabinoids prevent the development of behavioral and endocrine alterations in a rat model of intense stress (2012) · cites this paper as Yehuda et al, 1993
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Genetic predisposition and the development of posttraumatic stress disorder in an animal model
King, J. A., Abend, S., & Edwards, E. (2001) · Biological Psychiatry · doi:10.1016/s0006-3223(01)01071-x · Cited by 65
Hypothalamic–Pituitary–Adrenal Axis Activity and Sleep in Posttraumatic Stress Disorder
Otte, C., Lenoci, M., Metzler, T. J., Yehuda, R., Marmar, C. R., & Neylan, T. C. (2005) · Neuropsychopharmacology · doi:10.1038/sj.npp.1300676 · Cited by 64
Self-citationPlasma norepinephrine kinetics in patients with posttraumatic stress disorder
Murburg, M. M., McFall, M., Lewis, N., & Veith, R. C. (1995) · Biological Psychiatry · doi:10.1016/0006-3223(95)00044-5 · Cited by 63
Geiss, A., Rohleder, N., & Anton, F. (2011) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.07.021 · Cited by 61
Rasmusson, A. M., & Pineles, S. L. (2018) · Current Psychiatry Reports · doi:10.1007/s11920-018-0908-9 · Cited by 63
Biologic models of traumatic memories and post-traumatic stress disorder
McFARLANE, A. C., Yehuda, R., & Clark, C. R. (2002) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(01)00008-9 · Cited by 67
Self-citation
Metadata
- Authors
- Yehuda, R., Southwick, S. M., Krystal, J. H., Bremner, J. D., Charney, D. S., & Mason, J. W.
- Affiliations
- Yale University (US)
- Venue
- American Journal of Psychiatry
- Published
- 1993-01-01
- Volume
- 150
- Issue
- 1
- Pages
- 83-86
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W49144085
- Cited by
- 517
- References
- 18
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 8 · 2023: 6 · 2022: 7 · 2021: 10 · 2020: 16 · 2019: 11 · 2018: 21 · 2017: 21 · 2016: 16 · 2015: 21 · 2014: 5 · 2013: 15 · 2012: 20
- FWCI
- 6.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r03mh049536-02)
- National Institute of Mental Health (MH-49536)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- post-traumatic stress disorder, dexamethasone suppression test, cortisol, hypothalamic-pituitary-adrenal axis, negative feedback sensitivity, major depressive disorder, differential diagnosis, glucocorticoid receptor sensitivity
- MeSH terms
- Adult, Depressive Disorder, Dexamethasone, Diagnosis, Differential, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Pituitary-Adrenal System, Stress Disorders, Post-Traumatic
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